SHM Converge Scientific Abstract ePoster Gallery-Association of Covid-19 Infection With Psi-12 Events in a Multi-Site Health Care System

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This retrospective cohort study examined whether acute COVID-19 infection is associated with PSI-12 events, a hospital quality metric defined as perioperative pulmonary embolism (PE) or deep vein thrombosis (DVT). The study included 50,400 PSI-12-eligible encounters across three Mayo Clinic sites (Minnesota, Arizona, and Florida) from April 1, 2020 to October 4, 2021. Acute COVID-19 was defined by a positive test or diagnosis code during hospitalization.<br /><br />Among 257 encounters with acute COVID-19, PSI-12 occurred in 8 cases (3.11%). In contrast, among 50,143 encounters without acute COVID-19, PSI-12 occurred in 210 cases (0.42%). The unadjusted PSI-12 rate was therefore substantially higher in patients with COVID-19. After adjusting for the AHRQ/WinQI expected risk, the rate remained elevated (1.50% vs 0.38%).<br /><br />Review of the 8 COVID-19-associated PSI-12 cases showed that most were men, with a mean age of 50 years. The primary reason for hospitalization was COVID-19 pneumonia in nearly all cases. Events included PE in 5 patients and DVT in 3 patients. All required ICU care, and half died. Many had additional risk factors such as malignancy or morbid obesity, and in some cases the VTE occurred before surgery, suggesting the event was related to COVID-19 illness rather than preventable perioperative harm.<br /><br />The authors conclude that acute COVID-19 infection is associated with a roughly four-fold increase in PSI-12 risk. They recommend that acute COVID-19 remain excluded from the PSI-12 denominator, or that risk adjustment be improved, to avoid unfairly penalizing hospitals—especially tertiary and academic centers caring for the sickest patients.

Asset Subtitle

Shivang Bhakta

Meta Tag

Author List Benjamin Pollock, Jennifer B. Cowart, Pablo Moreno Franco, Shivang Bhakta, Young Erben

Category Research

Concept Patient Safety Indicator 12

Concept Acute COVID-19

Concept Retrospective Cohort Study

Concept Hospital Quality Indicator

Concept Patient Safety Indicator

Distinguished Non-Finalist

Presenter Organization Mayo Clinic

Presenting Author Shivang Bhakta

Track Value in Hospital Medicine

Keywords

acute COVID-19

PSI-12

perioperative pulmonary embolism

deep vein thrombosis

venous thromboembolism

hospital quality metric

retrospective cohort study

risk adjustment

Mayo Clinic

ICU care

Patient Safety Indicator 12

Acute COVID-19

Retrospective Cohort Study

Hospital Quality Indicator

Patient Safety Indicator